Public Perceptions on the Influence of Diet and Kidney Stone Formation

Public awareness regarding the influence of diet on kidney stones is unknown. We sought to evaluate such perceptions among an unselected community cohort. A survey was created to assess perception of beverages/foods on risk of kidney stone formation. Surveys were distributed to attendees of a State Fair. Participants were categorized to determine the effect of stone history on prevention knowledge (no prior stone vs prior stone). Seven hundred fifty-three participants completed the survey, including 264 (35%) with a prior stone. Participants with prior stones were less likely to believe stones were preventable compared to those without (56% vs 65%, p = 0.01). Appropriate perceptions regarding influence of diet on stones were highest for water (>90% of participants) and cola/salt/red meat (>50%). Fewer than half of respondents correctly identified the influence of the remaining 14 substances. On multivariable analysis, stone formers were more likely to correctly identify the influence of lemonade (odds ratio [OR] 2.09; 95% confidence interval [CI] 1.32-3.31), nuts (OR 2.60; 95% CI 1.60-4.23), and spinach (OR 5.06; 95% CI 2.89-8.86), but less likely to identify the influence of coffee (OR 0.43; 95% CI 0.23-0.82) and red meat (OR 0.52; 95% CI 0.23-0.59). Patients with prior stones hold different attitudes regarding the influence of certain foods and drinks on stone formation relative to the public. Such attitudes are not always correct, and as a group they are less likely to believe in dietary stone prevention. Such findings may indicate confusion among stone formers and highlight an opportunity for improved dietary counseling.